Healthcare Provider Details

I. General information

NPI: 1346888336
Provider Name (Legal Business Name): FARZAN BILLIMORIA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18301 N 79TH AVE STE H192
GLENDALE AZ
85308-8457
US

IV. Provider business mailing address

255 W CECILIAS LN
COTTONWOOD AZ
86326-5483
US

V. Phone/Fax

Practice location:
  • Phone: 623-215-2020
  • Fax:
Mailing address:
  • Phone: 850-287-5735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8871
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number5427
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: